How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $3.72 | Facility | None | $2.24 | $2.24 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $2.24 | Professional | None | $2.14 | $2.24 | $2.24 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
BCBS South Carolina Setting Facility Modifier None Typical Low $2.82 Median $4.07 Typical High $6.92 | Facility | None | $2.82 | $4.07 | $6.92 |
BCBS South Carolina Setting Professional Modifier None Typical Low $2.00 Median $2.14 Typical High $3.02 | Professional | None | $2.00 | $2.14 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.72 Typical High $5.25 | Facility | None | $3.02 | $3.72 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Medcost Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $21.38 | Professional | None | $2.57 | $2.57 | $21.38 |
Medcost Setting Facility Modifier None Typical Low $2.24 Median $2.51 Typical High $6.76 | Facility | None | $2.24 | $2.51 | $6.76 |
Medcost Setting Professional Modifier None Typical Low $2.04 Median $2.09 Typical High $16.98 | Professional | None | $2.04 | $2.09 | $16.98 |
Molina Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | None | $5.50 | $5.50 | $5.62 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.24 Typical High $2.29 | Professional | None | $1.74 | $2.24 | $2.29 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.07 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.45 Typical High $0.45 | Professional | 53 · Discontinued | $0.43 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.34 Typical High $0.34 | Professional | 55 · Aftercare only | $0.32 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.21 | $0.22 | $0.22 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1.05 Median $1.45 Typical High $23.44 | Professional | 51 · Multiple procedures | $1.05 | $1.45 | $23.44 |
Where South Carolina sits
The same service costs 1.9 times more in Wyoming than in Maine. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Carolina· 39th of 51
$2.14
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.